Capecitabine non-adherence: Exploration of magnitude, nature and contributing factors

Debi Bhattacharya, Claire Easthall, Kerri Anne Willoughby, Matthew Small, Steven Watson

Research output: Contribution to journalArticleAcademicpeer-review

83 Citations (Scopus)


Objectives: The prescribing of oral chemotherapy agents previously available only in the intravenous formulation, such as capecitabine, has afforded many benefits including reduced administration costs and improved patient acceptability. However, it has introduced the new challenge of ensuring patient adherence to therapy. It is therefore necessary to quantify adherence, and with a view to improving services, explore factors that may impact on medication taking behavior.

Methods: Patients with a diagnosis of breast or colorectal cancer and prescribed capecitabine were recruited from a UK teaching hospital. Data regarding self-reported adherence, beliefs about medicines, side effects, and satisfaction with
information received about capecitabine were recorded.

Results: Non-adherence was reported by 23.3% of the 43 participants. Capecitabine therapy was perceived necessary by 97.6%, but almost one-third of participants had strong concerns. Side effects were reported by 80% of participants, with Palmar–Plantar erythrodysesthesia and fatigue most troubling participants. Complete satisfaction with information received was reported by 65% of participants; however, dissatisfaction about how to tell if capecitabine is working and the proposed duration of therapy was expressed by 42.9% and 37.3% of participants, respectively.

Conclusions: Adherence to capecitabine is high with a strong conviction that the therapy is necessary. However, concerns were expressed regarding the experience of side effects. Patients have unmet information needs regarding the processes involved with monitoring capecitabine efficacy and determination of therapy duration. Healthcare professionals may therefore wish to consider a greater focus on involving patients in the monitoring of their care with respect to efficacy and planned treatment schedules.
Original languageEnglish
Pages (from-to)333-342
JournalJournal of Oncology Pharmacy Practice
Issue number3
Publication statusPublished - 1 Sept 2012
Externally publishedYes


  • Cancer
  • Oncology
  • Medication adherence
  • Capecitabine
  • Medication beliefs
  • Oral chemotherapy


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